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NPI Code Detail

MEDICARE: TRANQUILITY COUNSELING SERVICES LLC

MEDICARE: TRANQUILITY COUNSELING SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2101YM0800XMental Health Counselor
3101YP2500XProfessional Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801403332
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANQUILITY COUNSELING SERVICES LLC
Provider Business Mailing Address
First Line : 13330 DETROIT AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-2850
Country : US
Telephone Number : 216-539-7846
Fax Number :
Provider Business Practice Location Address
First Line : 13330 DETROIT AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-2850
Country : US
Telephone Number : 440-821-5820
Fax Number :
Authorized Official
Title or Position : CEO
Name : ELIAS COURY
Credential :
Telephone Number : 440-821-5820
Provider Enumeration Date : 09/29/2020
Last Update Date : 09/29/2020

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Directions to “TRANQUILITY COUNSELING SERVICES LLC ” Practice Location

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